Anaphylaxis during anaesthesia. Results of a two-year survey in France

Between January 1, 1997 and December 31, 1998, 467 patients were referred t o one of the allergo-anaesthesia centres of the French GERAP (Groupe d'Etud es des Reactions Anaphylactoides Peranesthesiques) network and were diagnos ed as having anaphylaxis during anaesthesia. Diagnosis was established on t he basis of clinical history, skin tests and/or a specific IgE assay. The m ost frequent cause of anaphylaxis was a neuromuscular blocking agent (69.2% ). Latex was less frequently incriminated (12.1%) than in previous reports. A significant difference was observed between the incidence of anaphylacti c reactions observed with each neuromuscular blocking agent and the number of patients who received each drug during anaesthesia in France throughout the study period (P <0.0001). Succinylcholine and rocuronium were most freq uently incriminated. Clinical reactions to neuromuscular blocking,drugs wer e more severe than to latex. The diagnostic value of specific IgE assays wa s confirmed. These results are consistent with changes in the epidemiology of anaphylaxis related to anaesthesia and are an incentive for the further development of allergo-anaesthesia clinical networks.